Provider Demographics
NPI:1508875436
Name:KNOWLES, SARAH ANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ANN
Last Name:KNOWLES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19721 WOLF RD
Mailing Address - Street 2:
Mailing Address - City:MOKENA
Mailing Address - State:IL
Mailing Address - Zip Code:60448-1307
Mailing Address - Country:US
Mailing Address - Phone:708-479-5865
Mailing Address - Fax:
Practice Address - Street 1:19721 WOLF RD
Practice Address - Street 2:
Practice Address - City:MOKENA
Practice Address - State:IL
Practice Address - Zip Code:60448-1307
Practice Address - Country:US
Practice Address - Phone:708-479-5865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0263611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice